Inflammatory markers and the risk of idiopathic sudden sensorineural hearing loss: A Mendelian randomization study.

Background: Observational studies suggest that inflammatory markers may increase the risk of idiopathic sudden sensorineural hearing loss (ISSHL). However, the causal relationship between the two has not been established. We sought to assess the possible causal effect between several genetically predicted inflammatory markers and ISSHL by Mendelian random (MR) analysis. Methods: We extracted single nucleotide polymorphisms (SNPs) associated with C-reactive protein (CRP), Tumor necrosis factor-α (TNF-α), and fibrinogen from abstract data from the European Individual Large genome-wide association studies (GWAS). Genetic data for ISSHL were obtained from the FinnGen study (n = 196,592). Effect estimates were assessed using inverse variance weighting (IVW) as the primary method. Sensitivity analyses were performed using weighted median, MR-Egger, and MR-PRESSO to evaluate heterogeneity and pleiotropy. Results: In the random-effects IVW approach, there was a significant causal relationship between genetic susceptibility to CRP levels and ISSHL (OR = 1.23, 95% CI = 1.02-1.49, P = 0.03). In contrast, genetic TNF-α and fibrinogen were not risked factors for ISSHL (OR = 1.14, 95% CI = 0.88-1.49, P = 0.30; OR = 0.74, 95% CI = 0.07-7.96, P = 0.30; OR = 1.05, 95% CI = 0.88-1.25, P = 0.59). All the above results were consistent after validation by different Mendelian randomization methods and sensitivity analyses. Conclusion: This Mendelian randomization study provides causal evidence that CRP is a risk factor for ISSHL, while TNF-α and fibrinogen do not increase the risk for ISSHL Introduction.

Clinical Features and Treatment of Congenital Pyriform Sinus Fistula: Analysis of 12 Cases.

BACKGROUND: Congenital pyriform sinus fistula (CPSF) is a rare congenital disease derived from the remnants of the third or fourth branchial cleft. OBJECTIVES: To investigate the imaging characteristics, clinical manifestations, surgical methods, complications, and personalized treatment of CPSF. MATERIAL AND METHODS: The clinical data of 12 CPSF patients admitted to the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Wenzhou Medical University from March 2016 to May 2021 were retrospectively analyzed. Cryogenic plasma radiofrequency ablation, carbon dioxide laser resection, and external cervical excision were selected based on the individual condition, and postoperative complications and efficacy were evaluated. RESULTS: There were 6 men and 6 women. Neck abscess or thyroiditis was considered at the initial diagnosis. In 11 of the cases, the CPSF was on the left side, whereas in the rest one case, it was on the right. A pyriform fossa fistula was observed during hypopharyngeal iodine angiography. Eight patients were treated with endoscopic piriform fossa fistula laser resection, two with cryogenic plasma radiofrequency ablation, and the rest with external cervical fistula resection. There was no evidence of postoperative hoarseness, pharyngeal fistula, dysphagia, and other complications. CONCLUSION AND SIGNIFICANCE: CPSF is less common in adults than in children. For patients with recurrent neck abscesses, CPSF should be highly suspected, timely angiography should be performed as soon as possible, and care should be taken to avoid missed diagnoses. The primary method for piriform fossa fistula removal is surgical treatment. Finally, tailoring treatment regimens to the patient's condition can significantly improve curative efficacy.

Migratory pharyngeal foreign bodies and related complications: Analysis of 20 cases.

PURPOSE: To explore the diagnostic approach and therapeutic method of migratory pharyngeal foreign bodies and related complications, to improve the understanding of such disease and to reduce misdiagnosis and missed diagnosis. MATERIAL AND METHODS: A retrospective study was performed by collecting patients who were treated because of the related complications caused by migratory pharyngeal foreign bodies from 2012 to 2020. RESULTS: A total of 20 patients were admitted to hospital due to the related complications. 14 cases showed cervical mass; 3 cases showed abscess of the mouth floor; 1 cases showed retropharyngeal abscess; 1 cases showed laryngeal granuloma; 1 cases showed mass of tongue. All patients received imaging examination of B-ultrasonography or computed tomography (CT). 19 patients were treated by surgery, and 1 patient was taken conservative treatment. All foreign bodies was successfully removed. As for the type of foreign bodies, there have 15 cases of fishbone, 2 cases of crabshell, 2 cases of shrimp shell, 1 cases of duck bone. CONCLUSIONS: Migrating foreign bodies and related complications are rare in clinic, much attention should be paid to avoid missed diagnosis or misdiagnosis.

Application of acellular dermal matrix to reconstruct the defects after hypopharyngeal carcinoma resection.

PURPOSE: Reconstruction of the defects and recovery of the laryngopharyngeal function after resection of hypopharyngeal carcinoma are crucial for patients to promote the rate of survival and the quality of life. We launched this study to explore the advantages and limitations of acellular dermal matrix applied in the reconstruction of the defects after hypopharyngeal carcinoma surgery. MATERIALS AND METHODS: Collected the clinical and pathological data of patients with hypopharyngeal carcinoma, divided them into 2 groups according to the repair materials used (pectoralis major myocutaneous flap or acellular dermal matrix). The clinical data and postoperative complications were analyzed and compared. RESULTS: No matter whether the pectoralis major myocutaneous flap or acellular dermal matrix was used to repair hypopharyngeal cancer resection defects, the postoperative complications, especially the pharyngeal fistula rate, were not significantly different. The postoperative drainage volume of patients with acellular dermal matrix was less than that of patients with pectoralis major myocutaneous flap. CONCLUSIONS: Acellular dermal matrix is a safe and effective biomedical material for hypopharyngeal cancer operation defects repair and pharyngeal function reconstruction, which can simplify the operation process, reduce the postoperative drainage volume, and decrease the risk of wound infection or pharyngeal fistula.

The Prognostic Value of Preoperative Plasma Fibrinogen and Neutrophil-to-Lymphocyte Ratio in Patients With Laryngeal Squamous Cell Carcinoma.

OBJECTIVES: Treatment effects in patients with laryngeal squamous cell carcinoma may vary significantly even among those with the same TNM stage. Routine preoperative blood and coagulation tests are economical and easily available hematological indicators. This study aimed to investigate the clinical predictive significance of pretreatment evaluation of plasma fibrinogen (FIB) level, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients with laryngeal carcinoma. METHODS: Clinicopathological and demographic data from 203 patients who underwent surgery for laryngeal carcinoma were collected and analyzed. The optimal cutoff values for FIB, NLR, and PLR were determined using receiver operating characteristic curve analysis. Univariate and multivariate Cox regression analyses were used to study the relationship between blood markers and patient survival. RESULTS: The optimal cutoff values for FIB, NLR, and PLR were 3.05 g/L, 2.41, and 110.94, respectively. Preoperative hyperfibrinemia (FIB >3.05 g/L) was an independent prognostic factor for overall survival (OS) and disease-free survival in patients with laryngeal carcinoma. An NLR >2.41 was associated with reduced OS in patients with laryngeal carcinoma, while PLR >110.94 had no effect on prognosis in these patients. CONCLUSIONS: Fibrinogen and NLR were valuable markers in predicting survival in patients with laryngeal carcinoma and may be used to inform clinicians in designing individual treatment strategies.

Impact of prior cancer history on the survival of patients with larynx cancer.

BACKGROUND: Patients with a prior history of cancer are commonly excluded from clinical trial. Increasing number of studies implied that a prior cancer did not adversely affect the clinical outcome among various types of cancer patients. However, the impact of prior cancer on survival of larynx cancer patients remains largely unknown. The aim of this study was to evaluate the prevalence of prior cancer and assess its impact on survival of patients diagnosed with larynx cancer. METHODS: Patients with larynx cancer as the first or second primary malignancy diagnosed from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was conducted to balance baseline characteristics. Kaplan-Meier method, multivariate Cox proportional hazard model, and multivariate competing risk model were performed for survival analysis. RESULTS: A total of 24,812 eligible patients with larynx cancer were included in the study, wherein a total of 2436 patients (9.8%) had a prior history of cancer. Prostate (36%), lung and bronchus (10%), urinary bladder (7%), and breast (6%) were the most common types of prior cancer. A prior cancer history served as a risk factor for overall survival (AHR =1.30; 95% CI [1.21-1.41]; P < 0.001) but a protective factor for cancer-specific mortality (AHR = 0.83; 95% CI [0.72-0.94]; P = 0.004) in comparison with those without prior cancer. The subgroup analysis showed that a prior history of cancer adversely affected overall survival of patients with larynx cancer in most subgroups stratified by timing and types of prior cancer, as well as by different clinicopathologic features. CONCLUSION: Our study indicated an adverse survival impact of a prior history of cancer on patients with larynx cancer. Except for a few particular prior cancer, clinical trials should be considered prudently for laryngeal cancer patients with prior cancers.